Abstract: A vaginal manipulator includes a shaft, a handle connected to a first end of the shaft, and a head connected to a second end of the shaft. The head includes a rigid anterior surface that moves independently from a rigid posterior surface of the head. When the vaginal manipulator is inserted into a vagina, the rigid anterior surface is movable to displace an anterior wall of the vagina and the rigid posterior surface is movable to displace a posterior wall of the vagina. A light source is provided on the head.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A Perineal elasticity meter having a circular central stem marked with millimeter markings and a sleeve portion surrounding the circular stem. Hinges connect the sleeve to expanders that extend from the circular stem. The perineal elasticity meter is configured to be inserted into the vagina of a patient in order to measure the elasticity of the perineal area. The sleeve includes an opening that shows a circumferential measurement achieved by the expansion of the expanders, as the sleeve moves along the central stem. Another perineal elasticity meter includes two stems connected via a hinge at a proximal portion of the stems. The proximal portions of the stems are configured to be inserted into the vagina of a patient and a measurement is taken of a distance between the expanded distal portion of the stems, thereby measuring the elasticity of the perineal area.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical refractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: A surgical access port and method for achieving articulation is disclosed, the surgical access port including a housing, at least one lumen extending through the housing, and an articulation structure. The housing comprises an access member having a proximal end and a distal end, and defines a longitudinal axis. The lumen in the housing extends from the proximal to the distal end of the access member along the longitudinal axis. The articulation structure comprises a first tubular member and a second tubular member, the second tubular member hingably attached to the first tubular member, and an articulation element slidably attached to the first tubular member.

Abstract: A retractor assembly for defining a working channel to a surgical site for conducting minimally invasive spinal surgery includes a plurality of relatively articulable components. Temporary interconnections are formed between adjacent sidewalls of the components to hold the components in a desired configuration, such as in a closed triangular form. The components are articulable relative to each other for adjusting the working channel or for performing surgical functions.

Abstract: An instrument capable of providing large-area shielding within an isolated operating region, such as the eye, while being passable through a small incision in the region through which the instrument must be inserted. For example, an instrument capable of being passed through a typical 3 mm (or smaller) phacoemulsification incision without undue damage to ocular tissue, and which expands to provide large-area shielding, e.g. to occlude a large-diameter (e.g. approx. 6 mm) posterior capsule opening. The surgical instrument includes two or more leaves, the leaves being interconnected by at least one fastener in a manner that causes expansion of a leading or distal portion of the instrument when the following or proximal portions of each leaf are manipulated, whether by a user or through interaction with a wall of the incision.

Abstract: A speculum insertable into a body cavity of a person including a support member having an opening, provided with elongated arm sections each disposed in a plane including a centerline of such opening, blade members each lying in the plane of an arm section and having an intermediate section pivotally connected to the support member, a first end section displaceable into and out of engagement with the end section of another blade member and a second end section displaceable relative to one of the arm sections, means for releaseably biasing the first end sections of the blade members into engagement, permitting such end sections to be inserted into and removed from a body cavity, and means mounted on each arm member, engageable by a second end section of a blade member, for camming such blade member to pivot about the axis thereof.

Abstract: A medical instrument serves for creating an access for a minimally invasive intervention and has a body having a longitudinal axis. The body is assembled of at least two parts, each of said parts having edges extending along a direction of said axis. Each of said parts having edges extending along a direction of said axis. Each part has a distal section merging into a proximal section standing outwardly from said longitudinal axis. In a first position, the distal end section of the parts are joined along said edges to form a distal body with the proximal section standing away. In a second position, the proximal sections of said parts are joined along said edges to form a hollow proximal body with said distal end section spreaded outwardly. The edges are provided with interacting features which are designed to block a lateral sliding of said joined parts transversely to said edges.

Abstract: A transvaginal ultrasound probe speculum is designed for use with a generally cylindrical elongated ultrasound probe. The speculum has an elongated blade having a proximal end and a distal end, and a connector, such as a collar. The speculum has a lever that cooperates with the collar and the elongated blade for pivoting the blade relative to the ultrasound probe so that the blade and the ultrasound probe serve as the blades of the speculum.

Abstract: Methods and devices for retracting tissue in a surgical procedure to allow access to the surgical site. Retractor systems and methods that comprise a retractor frame comprising rotatable arms and a linearly translatable arm, the rotatable arms and the linearly translatable arm each coupled to blades that can angulate.

Abstract: A method for accessing a spinal disc of a lumbar spine of a patient using a surgical access system including a tissue distraction assembly and a tissue retraction assembly. The method can include maintaining an operative corridor along a lateral, trans-psoas path using the retraction assembly.

Abstract: A medical access device for creating an access to a body for minimally invasive intervention has a hollow body assembled from at least two parts having longitudinal extending edges. Each part has a distal body portion and at an angle to the latter a proximal body portion. A locking mechanism locks the assembled proximal hollow body portions. The locking mechanism has a hook projecting from an edge of a proximal body. A nose of the hook can enter from proximal to distal in a recess in an edge joining said edge having said hook.

Abstract: A bone access tool including a handle assembly and speculum assembly coupled to the handle assembly for accessing and channeling through biological tissue is described. The handle assembly has first and second portions that are movable relative to one another. The speculum assembly has first and second speculum members movably positioned relative to one another. The speculum members define an internal shaft arranged about a central axis and a tapered shape when positioned adjacent one another. The tapered shape gradually reduces in size from a proximal rim to a distal edge of the speculum assembly. Actuation of the handle assembly causes the first speculum member and second speculum member to spread apart from one another about the central axis so as to retract anatomical tissue and widen a size of the internal shaft for deploying a tool into the internal shaft between the speculum members.

Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: An orthopedic surgery system includes: a retractor support arm; a table mounting assembly for securing the retractor support arm to the operating table; a first blade mounting arm slidably engaging the retractor support arm; a second blade mounting arm slidably engaging the retractor support arm in spaced relationship with respect to the first blade mounting arm; a first retractor blade connected to the first blade mounting arm; a second retractor blade connected to the second blade mounting arm; and a plate support assembly for releasably engaging an orthopedic plate wherein the plate support assembly slidably engages at least one of the retractor support arm or the first blade mounting arm or the second blade mounting arm. In one version of the invention, the system used in anterior cervical spine surgery and the orthopedic plate is an anterior cervical plate.

Abstract: A surgical access device includes a body having a first member and a second member relatively movable between open and closed configurations. Each member is positionable within an opening in tissue to provide access to an interior space of a patient. Each member includes a top surface, a bottom surface, a leading end, and a trailing end. The top surfaces are positioned in close cooperative alignment when the first and second members are in the closed configuration. The trailing ends are positioned in close cooperative alignment when the first and second members are in the open configuration. In the open position, the first and second members define a passage therethrough to permit access to the interior space for passage of a surgical instrument therethrough.

Abstract: A retractor includes a first arm, a second arm, and a translating member. The first arm comprises a proximal portion configured to retain a first retractor member and a distal portion configured to rotate relative to the proximal portion about a first axis. The second arm is configured to retain a second retractor member, such that rotation of the distal portion about the first axis causes the first retractor member to pivot toward or away from the second retractor member when the first retractor member and the second retractor member are coupled to the first arm and the second arm, respectively. The translating member is coupled between the proximal portion and the distal portion, and is configured to receive a drive force that causes the translating member to bias the distal portion to pivot relative to the proximal portion about the first axis.

Abstract: A surgical access system includes retractor for creating an access path between an incision site and a surgical site. The retractor includes a frame having a base member and a pair of generally curved rails extending therefrom. A tubular member is coupled to the frame and includes first and second blade portions that are capable of relative movement with respect to each other by movement on the curved rails. A method of inserting the retractor into a patient includes inserting a guide rod over a guide wire, locating an obturator in the retractor, inserting the obturator and retractor over the guide rod, and removing both the guide rod and obturator to leave the retractor in the body to provide the access path.

Abstract: A retraction apparatus and method are provided including slider assemblies for being slidably connected to a retractor body with end portions of the slider assemblies disposed within a central retractor opening. A retractor blade is slidably connected to one of the slider assembly end portions such that the depth of the retractor blade can be readily adjusted. Once the retractor blade is at the desired depth within the incision, a handle is pivoted to a locked position to fix the blade relative to the slider assembly. A cantilever lock between the blade and the slider assembly pivots the blade relative to the slider assembly to fix the blade thereto. In one form, the retractor body has a substantially flat surface configured to be placed adjacent a bone and slide connections which position slider assemblies such that the connected blades avoid contact with the bone during retraction.

Abstract: A tissue support device is provided for managing access through tissue. The tissue support device engages the tissue proximate an opening in the tissue and biases the tissue support device to bring the engaged tissue together.

Abstract: A device for expanding an elongate opening formed in a skin layer of a patient includes a first arm for engaging one side of the opening and a second arm for engaging the other side of the opening. The device further includes a spreader mechanism, coupled to at least one of the first and second arms, to move the at least one of the first and second arms to widen the opening. The at least one arm is configured to move between a retracted position in which the at least one arm is positioned next to the other arm and an extended position in which the at least one arm is extended to expand the opening. Other embodiments of the device as well as methods for performing a medical procedure are further disclosed.

Abstract: An assembly for tissue retraction in surgery includes a pair of arm members removably positioned on and movable along an elongate support member. The arm members each include an external housing, a locking member positioned within the external housing and a passageway extending through the external housing and the locking member. The elongate support member extends through the passageways and the locking members are releasably biased into engagement with the elongate support member to allow the arm members to move in opposite directions along the elongate support member and prevent the arm members from moving toward one another. Each arm member further includes a rotatable engagement portion engageable with a respective retractor portion and a locking element releasably biased into engagement with the engagement portion to limit rotation of the engagement portion to a first direction relative to the arm member.

Abstract: A surgical access device includes a frame defining an aperture, first and second support members mounted on the frame, and first and second retractor blades releasably coupled with the first and second support members, respectively. The first and second retractor blades each include a distal portion defining a recess having an arcuate profile, wherein the first and second retractor blades are movable between a close cooperative position and a spaced apart position with respect to each other.

Abstract: Disclosed are devices and methods for accessing and channeling through biological tissue. One embodiment is a bone access tool including a handle assembly and speculum assembly coupled to the handle assembly. The handle assembly has first and second portions that are movable relative to one another. The speculum assembly has first and second speculum members movably positioned relative to one another. The speculum members define an internal shaft arranged about a central axis and a tapered shape when positioned adjacent one another. The tapered shape gradually reduces in size from a proximal rim to a distal edge of the speculum assembly. The speculum assembly also has at least one rib extending outwardly from each of the first and second speculum members, the rib having an upper surface and an inclined lower surface.

Abstract: A device, system and method for orthopedic spine surgery using a screw-based retractor, are disclosed herein and allows for access to the spine through a minimally or less invasive approach. The retractor device is designed to be coupled to a pedicle screw and then to have opposed arms of the retractor spread apart to open the wound proximally. The retractor is removed by separating the opposed blades to allow the retractor portions to be pulled out of the wound. The retractor is intended to be made of a flexible metal material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

Abstract: A device for expanding an elongate opening formed in a skin layer of a patient includes a first arm for engaging one side of the opening and a second arm for engaging the other side of the opening. The device further includes a spreader mechanism, coupled to at least one of the first and second arms, to move the at least one of the first and second arms to widen the opening. The at least one arm is configured to move between a retracted position in which the at least one arm is positioned next to the other arm and an extended position in which the at least one arm is extended to expand the opening. Other embodiments of the device as well as methods for performing a medical procedure are further disclosed.

Abstract: Methods and devices are provided for controlling movement of an end effector assembly, and in particular for causing mimicking motion between a handle and an end effector assembly. In an exemplary embodiment, a surgical device is provided having a handle or actuator, an elongate shaft, and an end effector assembly coupled to a distal end of the elongate shaft. The handle or actuator is configured such that movement of the handle is mimicked, not mirrored, by the end effector assembly. The mimicking motion can be achieved using various techniques, but in an exemplary embodiment the handle is located distal to an input joint, and motion is transferred to the end effector assembly through an output joint at a distal end of the elongate shaft. The motion is preferably transferred using a mechanical transmission coupled between the input and output joints.

Abstract: A speculum includes upper and lower members and a linear support member. The upper member includes an upper blade. The lower member includes a lower blade and a handle portion. The lower blade includes a support structure at a proximal end thereof which extends vertically on the right or left side of the lower blade, and a handle portion extending downwardly from the lower blade and defining a vertical track. The linear support member has a proximal end pivotally connected to the upper blade, a distal end, and an elongated body between the proximal and distal ends. The elongated body slidably engages the vertical track of the handle portion. The linear support member is formed with a hidden slot which slidably receives the support structure of the lower blade.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A retractor device for cervical spinal fusion surgery. The retractor device includes a first post assembly having a first pin for mounting the first post assembly to a first vertebral body and a first rod coupled thereto in a multi-axial manner so that the first rod can be pivoted relative to the first pin. The retractor device also includes a second post assembly having a second pin for mounting the second post assembly to a second vertebral body and a second rod coupled thereto in a multi-axial manner so that the second rod can be pivoted relative to the second pin. The retractor device also includes a first retractor blade having a first retractor blade arm slideably engageable to the first rod, and a second retractor blade having a second retractor blade arm slideably engageable to the second rod. The first retractor blade is slid down the first rod and the second retractor blade is slid down the second rod to be positioned and separate the anatomical structures.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Embodiments of the invention include instruments and methods for providing surgical access to a surgical site. Some embodiments include a flexible arm that adjustably holds a retractor blade to enable access to the surgical site.

Abstract: A surgical access device can include a plurality of retractor members that together define a lumen having a first cross-sectional dimension. Each of the plurality of retractor members can be moved radially outward to at least a second cross-sectional dimension to create a surgical access passage. The surgical access device, systems and kits comprising the surgical access device, and methods of using the surgical access device can include a mechanism for inserting an elongate member from exterior the body to the surgical site, a mechanism for moving the retractor members radially outward, a mechanism for guiding the radially outward movement of the retractor members, a mechanism for securing each of the retractor members in a range of positions, and a mechanism for illuminating the surgical site. Variations of the devices, systems, kits, and methods are useful for creating and maintaining a surgical access passage for performing minimally invasive surgery.

Abstract: Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

Abstract: An apparatus and method for an examination apparatus that includes a manually movable structure having a first movement from a free state to a compressed state and a second reversing movement from the compressed state to the free state. Also included is a plurality of fingers that are disposed adjacent to the structure. The fingers having a stowed state and an open state, the stowed state having a nested relationship between the fingers to reduce a silhouette profile size. In moving from the stowed state to the open state of the plurality of fingers requires a selected sequential movement of each the fingers to proceed from the nested relationship to the open state that is accommodated by an assemblage for moving the fingers sequentially utilizing the manually operated structure, wherein the fingers are moved from the stowed state to the open state and reversed manually.

Abstract: A system and method for inserting an implant into a cavity is disclosed, which may include advancing an implant insertion instrument toward a pair of adjacent bodies, the implant insertion instrument having two opposed ramps, wherein each ramp has a distal tip and wherein the longitudinal axes of the opposed ramps are separated by an initial angle; inserting the distal tips of the opposed ramps between the adjacent bodies, thereby creating an initial interbody cavity between the adjacent bodies; expanding the interbody cavity while maintaining the initial angle between the longitudinal axes of the opposed ramps; placing the implant in a final location between the adjacent bodies; transferring a compressive force urging the adjacent bodies together from the opposed ramps to the implant; and extracting the implant insertion instrument from the interbody cavity.

Abstract: This invention includes surgical retractors that comprise an expandable frame that includes at least two base components, a connector, and at least two retractor blades attached to the expandable frame. Also included are surgical retractors that comprise a housing component that includes a cylindrical portion and a contiguous blade portion, assemblies comprising a surgical retractor assembled to at least one obtruator, illuminated surgical cannulas, and methods of using the same during a surgical procedure.

Abstract: a minimal incision maximal access system allows for maximum desirable work space exposure within the incision along with maximum access to the operative field utilizing a minimum incision as small as the width of the working tube. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing retractors depending from a bi-hinged frame having internal or external controls to control the angle and separation of the retractors. Interchangeable retractor blades can be attached to the frame. Both retractor blades are independently controlled as to displacement and angle.

Abstract: Methods and devices for retracting tissue in a surgical procedure to allow access to the surgical site. Retractor systems and methods that comprise a retractor frame comprising rotatable arms and a linearly translatable arm, the rotatable arms and the linearly translatable arm each coupled to blades that can angulate.

Abstract: A self-retaining retractor is described. The retractor can be sized for small patients, such as young children or infants or some animals. The retractor has two blades that are capable of holding tissue separated during a procedure, such as a tracheotomy.

Abstract: A surgical retractor and a method of minimally invasive surgery, wherein the surgical retractor includes ribs and a mechanism for transferring of linear and rotational movements of the ribs and wherein each rib can be easily replaced without use of any additional tools. According to embodiments of the present invention, specific parts composing the surgical retractor are made of materials transparent to Röntgen rays (x-rays).

Abstract: A device for surgical operations on a prolapse, comprising a hollow stretcher body (2) having a prevalent development direction along a longitudinal axis (A) and being insertable in an orifice, the stretcher body (2) exhibiting a through-window (7), defining an area of intervention and realising a communication between an internal cavity (3) of the stretcher body (2) and a portion of a prolapse, a mobile wall (8) defining the through-window (7) in combination with the stretcher body (2) and being slidably associated to the stretcher body (2) in order to open and/or close the through window (7) between a configuration of minimum extension and a configuration of maximum extension of the through-window (7); characterised in that it comprises means for blocking (10) which act between the mobile wall (8) and the stretcher body (2) in order to maintain the through-window (7) stably in the configuration of minimum extension during insertion of the stretcher body (2).

Abstract: A surgical access assembly includes first and second wings disposed in opposed relation relative to one another. Each wing includes a body portion, a distal portion and first and second portions. A side wall section hingedly connects the body portions of the wings to one another at the first portion thereof and at the second portions thereof. Each of the side wall sections is movable with respect to the other side wall sections between a first position and a second position wherein each of the side wall sections is angled with the first and second wings. The first and second wings are moveable between an approximated position corresponding to the first position of the side wall sections and a spaced apart position corresponding to the second position of the side wall sections.

Abstract: Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.

Abstract: A surgical retractor including a pair of handles mounted for pivotal movement about a pivot pin, a pair of arm members each terminating at a distal end in a downwardly depending blade and attachable to a respective handle at a proximal end. On application of hand pressure by an operator to the pair of handles of the surgical retractor rotates each handle and arm member about the pivot pin and causes the blades to move apart so that in use in a surgical site the blades abut against and retract tissue matter.

Abstract: Methods and devices retract tissue for minimally invasive surgery in a patient. A retractor includes a working channel formed by a first portion and a second portion. The first and second portions are movable relative to one another from a first configuration for insertion that minimizes trauma to skin and tissue to an enlarged configuration after insertion to further retract skin and tissue in a minimally invasive manner. Instruments are engageable to the first and second portions and operable to move the first and second portions relative to one another.

Abstract: Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.

Abstract: A device for retracting tissue provides access to a spinal location within a patient. The device includes an elongate body and a passage. The elongate body has a proximal portion and a distal portion. The elongate body defines a length between the proximal and distal portions along a longitudinal axis such that the distal portion can be positioned inside the patient adjacent the spinal location while the proximal portion is accessible. A transverse cross-section of the elongate body in the proximal portion has a first dimension that is longer than a second dimension. The first dimension is perpendicular to the second dimension. The passage extends through the elongate body between the proximal and distal portions. The elongate body is configured such that the proximal portion may be tilted with respect to the distal portion in a first direction generally aligned with the first dimension and in a second direction generally aligned with the second dimension.